• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 2493
  • 1716
  • 323
  • 233
  • 166
  • 163
  • 118
  • 92
  • 76
  • 39
  • 31
  • 26
  • 26
  • 21
  • 8
  • Tagged with
  • 6290
  • 1598
  • 1520
  • 1516
  • 1266
  • 564
  • 374
  • 357
  • 350
  • 331
  • 320
  • 314
  • 308
  • 305
  • 299
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
71

Renal Transplant Survey: how standardised is a standard kidney transplant?

Wicht, Jonathan H January 2017 (has links)
Aim: The primary intention of the current study was to discover if there are international standards in renal transplantation. Method: A questionnaire was created using an online survey tool (Qualtrics ®), and distributed to a list of email addresses supplied by the unit's senior transplant surgeon. A literature review was performed on the questions and on the history of transplantation. Ethics was approved by FHS HREC number 193/2015. Results: A total of 30 surveys were completed from a total of 147 emails sent (20.4%). Two thirds of respondents work exclusively in the public sector and almost two-thirds (63.3%) of the respondents had been involved in transplantation for over 10 years. Two thirds of the surgeons estimate that their units perform more than 60 transplants per annum. Only 30% (9/30) use living donors in more than 50% of their surgeries. Most (53.3%) perfuse the kidneys both in the donor (in situ) and outside (ex situ or ex vivo). If no anatomic abnormalities were noted in open living donor nephrectomy, 63.3% would prefer to use the left kidney, and the recipient transplantation would be performed on the right side (76.7%). The majority (90%) of surgeons would preserve the vas deferens, but sacrifice the round ligament and inferior epigastric vessels (76.7% and 80% respectively). There is no marked difference for use of either the internal or external iliac artery for the arterial anastomosis, but most use the external iliac vein for venous anastomosis (86.7%). 80% use a ureteroneocystostomy with a tunnel, and 60% use a DJ stent or ureteric catheter and closed suction drain routinely. Two thirds would remove the transurethral catheter on day 4-7 post operatively. 80% routinely biopsy the kidney, and 63.3% would biopsy prior to treating for possible acute renal rejection. Discussion: These results compare with some of the studies found in the literature and operative textbooks. There do appear to be standards noted between most of the respondent's answers. Conclusion: There do appear to be standards for renal transplantation and these are appreciated globally.
72

The Incidence of Inguinal hernia recurrence after Laparoscopic herniorrhaphy - a retrospective multicentre cohort study of patients operated on at a private practice in Cape Town

MacGuire, Colin Iain January 2012 (has links)
Includes bibliographical references. / The primary outcome will be the incidence of hernia recurrence. Secondary outcomes will be the incidence of post-operative and long-term pain and complications.
73

Foley catheter balloon tamponade for penetrating neck injuries at Groote Schuur hospital: an update

Scriba, Matthias Frank 29 October 2020 (has links)
Introduction Foley catheter balloon tamponade (FCBT) for bleeding penetrating neck injuries (PNIs) is an effective, readily available and easy-to-use technique. This study aims to audit the technique and highlight current investigative and management strategies. Methods All adult patients (18 years and older) with PNIs requiring FCBT presenting to Groote Schuur Hospital (GSH) within a 22-month study period were included. Data was captured from an approved electronic registry and analysed. Analysed parameters included demographics, major injuries, imaging, management and outcomes. Results Over the study period a total of 628 patients with PNI were managed at GSH, in which 95 patients (15.2%) FCBT was utilised. The majority were men (98%) with an average age was 27.9 years. Most injuries were caused by stab wounds (90.5%). The majority of catheters (81.1%) were inserted prior to arrival at GSH (1.1% prehospital, 45.3% at clinic level and 34.7% at district hospital level). Computerised tomography (CT) angiography was used in 92.6% of patients, while 8 patients (8.4%) required formal angiography. Of these, 2 were purely diagnostic and 6 were performed for definitive endovascular management. A total of 34 arterial injuries (19 major and 15 minor) were identified in 29 patients. Ongoing bleeding was noted in three patients, equating to a 97% success rate at haemorrhage control. Thirteen (13.7%) patients requried open neck surgery. Seventy-two (75.8%) patients without major arterial injury had removal of the catheter at 48-72 hours post injury. Only two of these had bleeding on catheter removal. Fifteen patients required ICU admission. A total of 36 separate morbidities were documented in 28 patients (29.5%). There were 4 deaths (4.2% mortality rate), with only one of these attributable to uncontrolled haemorrhage from the neck wound. Conclusion This large series shows the current use of FCBT for PNI. It highlights ease of use, high rates of success at haemorrhage control (97%) and good outcomes with the technique. Venous injuries and minor arterial injuries can be managed with this technique definitively.
74

Soft tissue Reconstruction of Gustilo-Anderson Grade IIIB Open Extra-Articular Tibial Fractures at a Tertiary Hospital in Cape Town, South Africa: A Retrospective Case Series

Barouni, Elyas 23 December 2020 (has links)
Introduction: Management of Gustilo-Anderson grade 3b tibia fractures are challenging due to the high rate of complications which includes infection, nonunion and possible amputation. Due to limited soft tissue coverage of the tibia antero-medially, open fractures remain a treatment challenge. Despite many advances, the ideal time delay to definitive soft tissue cover remains controversial. Aim: We aimed to investigate the management strategy and the outcome of soft tissue reconstruction of Gustilo-Anderson grade 3b tibia fractures at a tertiary hospital in Cape Town, South Africa. Methods: A retrospective study was conducted on 22 patients who underwent soft tissue reconstruction for grade 3b tibia fractures from January 2014 to July 2017. Patient demographics, comorbidities, injury characteristics and management practices such as time to debridement, relook time, Negative Pressure Wound Therapy (NPWT), soft tissue coverage and complications were recorded. Results: Most patients were males (n=18; 81.8%) with an average age of 39.3 years. Pedestrian vehicle accidents accounted for 45.4%(n=10), motor-vehicle accidents (n=6; 27.3%) and gunshot wounds (n=2; 9.1%). The commonest site of injury was the middle third of the tibia (n=13; 59.1%), distal third (n=7; 31.8%) and proximal third (n=2; 9.1%). Most patients (n=18; 81.8%) were debrided within 24 hours. The mean times for NPWT prior to cover was 12.5 days and for soft tissue cover 13.7 days (range 2-35), respectively. Fasciocutaneous flaps (n=11; 50%) were predominantly used as cover, then pedicled muscle flaps (n=8; 36.4%), free flaps (n=2) and skin graft(n=1). Most patients (n=13; 59.1%) received satisfactory outcomes. Seven (31.8%) required soft tissue revisions. Three patients (13.6%) suffered complications namely, complete flap loss resulting in amputation, partial skin graft loss and soft tissue infection, respectively. Patients who underwent debridement after 24 hours reported the least complications and there appeared to be better outcomes in the relooks beyond 48 hours. Conclusion: Despite achieving outcomes which concur with other published studies, the BOAST 4 guidelines were not fully reflected in our management strategy. We will require larger numbers in future studies to formulate a standardized management protocol going forward.
75

Describing the resistance patterns of necrotising fasciitis in Acute Care Surgery

Mabogoane, Tumiso January 2020 (has links)
Objective: This study aims to identify the microorganisms and antibiotic resistance patterns in necrotising fasciitis. Methods: This is a retrospective audit over two consecutive years (June 2015 - July 2017) of all patients who had surgery for necrotising fasciitis at an ACS unit. Results: Necrotising fasciitis accounted for 15% of all skin and soft tissue sepsis that required surgery. There were 10 male (52.6%) and nine female (47.4%) patients. The most common co-morbidity was diabetes mellitus in 10 (52.6%) patients, the compliance and control were monitored by glycosylated haemoglobin (HbA1C) in 50% of the diabetic group, with a mean of 8.98 (Range 5-12.9). Fifteen percent of cases (n=3) had a confirmed diagnosis of HIV, with a negative result in eight (42%). ICU was required in three patients two of whom were on inotropes and one patient required renal replacement therapy. Surgery was performed within 24 hours for 11 (57%) patients. The most common anatomical site for debridement was perineum in nine patients (47%). Monomicrobial infection was the most common subtype of necrotising fasciitis with methicillin sensitive staphylococcus aureus in five (26%) as the predominant microbe. Gram-negative organism Escherichia-coli was the second most common monomicrobial infection. All Gram-positive organisms were sensitive to cloxacillin and coamoxiclavulanic acid. Two gram negatives(15%) of the 13 organisms cultured were resistant to co-amoxiclavulanic acid. The 30 day mortality was 15%. Conclusion- Necrotising fasciitis is a rare but lethal infection. In our limited series, monomicrobial infection is the most common subtype. 15% of the community acquired organisms were resistant to the empiric antibiotic of choice co-amoxiclavulanic acid.
76

Variations in charge patterns in the operating room a report submitted in partial fulfillment ... for the degree of Master of Science (Nursing Administration) ... /

Taylor, Mary E. January 1995 (has links)
Thesis (M.S.)--University of Michigan, 1995.
77

Clinical outcomes of transpalatal distraction for transverse maxillaryhypoplasia: a retrospective study

Lee, Chee-wei., 李志維. January 2013 (has links)
Aim of study The aim of this clinical retrospective study is to evaluate the clinical outcomes of patients with transverse maxillary hypoplasia who underwent surgical assisted maxillary expansion (SARME) using a bone borne distractor in 2 different surgical centers. Patients and Methods This is a clinical retrospective cross‐sectional study of adult patients diagnosed with maxillary transverse hypoplasia and having had transpalatal distraction by SARME done in two surgical centers (Oral and Maxillofacial Surgery, The University of Hong Kong, Hong Kong and The Baruch Padeh Medical Center, Poriya, Israel) from January 2004 to December 2011. A total of 37 patients were identified. The mean age was 27.1. Each patient underwent a standard Le Fort I osteotomy with midline split with no mobilization under general anesthesia. A bone‐borne palatal distractor was fitted on the hard palate. The distractor was activated at a rate of 0.6mm per day following 5 ‐ 7 days of latency until the amount of expansion was reached according to plan. Occlusal radiographs and lateral cephalographs were obtained at pre‐expansion phase and regular postoperative intervals during the activation and consolidation period. Among the 37 patients, only 15 patients could be contacted by phone, mail or e‐mail and has agreed to participate in the cross‐sectional analysis. Clinical examination was performed and included the following: tooth vitality, tooth mobility, periodontal status and occlusion. Questionnaire was also given to patients to grade their experiences toward the treatment outcome. Results The mean transverse expansion achieved was 9.58mm. The TPD was removed from the patients in the ranged of 2 months to the longest 8 months (mean: 5.2 months). The distraction gap was gradually ossified by bone and then the teeth were aligned into the space achieving stable dental occlusion. No intra‐operative complications were recorded. Post‐operatively, 2 patients had to be re‐operated due to failure to activate the distractor. Others post‐operative complications encountered were pain, fixation screw loosening, insufficient distractor length, infection, asymmetric expansion and tooth migration into the distraction gap. These complications were well managed accordingly. Majority of the patients were satisfied with the treatment and will recommend it to others. Conclusions Correction of maxillary transverse hypoplasia using a transpalatal distractor can reliably achieve large bony expansion of the maxillary arch with few postoperative complications. / published_or_final_version / Dental Surgery / Master / Master of Dental Surgery
78

Resorbable Bone Cement for Augmentation of Hip Fracture

Mattsson, Per January 2005 (has links)
Surgical treatment of hip fractures is frequently associated with secondary fracture displacement, in part due to weak osteoporotic bone. So far, improvements have focused on new metal implants although an alternative could be to augment the bone that surrounds the implant. The aim of this thesis was to evaluate the use of calcium phosphate cement (Norian SRS) for augmentation of internally fixed hip fractures. Norian SRS is an injectable, biocompatible cement that hardens in situ without exothermic reaction. Over time it is remodeled and replaced by host bone. In a biomechanical study the holding characteristics for different implants was measured when inserted with or without augmentation. The study showed that conventional bone cement (PMMA) improved maximum torque and pull-out for almost all modalities while Norian SRS increased the holding power mainly in low-density bone. In a prospective and randomized study, patients with displaced femoral neck fractures were operated with internal fixation using screws alone or combined with Norian SRS for augmentation. The result showed improved stability when measured with radiostereometry (RSA) for the augmented fractures during the early rehabilitation period. The clinical evaluation of 118 patients included pain, walking aid, activities of daily living (ADLs), abductor muscle strength, mobility and range of motion. During the early course the augmented patients did better in some variables although over the total two-year study period there was no major difference between groups. Scintigraphic evaluation indicated that augmentation might compromise the circulation to the femoral head. The final part included unstable trochanteric fractures fixed with a sliding screw device alone or the same device combined with Norian SRS for augmentation. Using RSA it was shown that augmentation significantly improved the fracture stability until healing. In a randomized multicenter study including 112 patients, augmentation with Norian SRS reduced pain during early rehabilitation and improved quality of life until healing. In conclusion, augmentation with Norian SRS improved the early fracture stability in displaced femoral neck fractures while there was no major difference in clinical outcome. In unstable trochanteric fractures augmentation provided improved fracture stability and improved clinical course until healing.
79

Resorbable Bone Cement for Augmentation of Hip Fracture

Mattsson, Per January 2005 (has links)
<p>Surgical treatment of hip fractures is frequently associated with secondary fracture displacement, in part due to weak osteoporotic bone. So far, improvements have focused on new metal implants although an alternative could be to augment the bone that surrounds the implant. </p><p>The aim of this thesis was to evaluate the use of calcium phosphate cement (Norian SRS) for augmentation of internally fixed hip fractures. Norian SRS is an injectable, biocompatible cement that hardens in situ without exothermic reaction. Over time it is remodeled and replaced by host bone. </p><p>In a biomechanical study the holding characteristics for different implants was measured when inserted with or without augmentation. The study showed that conventional bone cement (PMMA) improved maximum torque and pull-out for almost all modalities while Norian SRS increased the holding power mainly in low-density bone. </p><p>In a prospective and randomized study, patients with displaced femoral neck fractures were operated with internal fixation using screws alone or combined with Norian SRS for augmentation. The result showed improved stability when measured with radiostereometry (RSA) for the augmented fractures during the early rehabilitation period. The clinical evaluation of 118 patients included pain, walking aid, activities of daily living (ADLs), abductor muscle strength, mobility and range of motion. During the early course the augmented patients did better in some variables although over the total two-year study period there was no major difference between groups. Scintigraphic evaluation indicated that augmentation might compromise the circulation to the femoral head.</p><p>The final part included unstable trochanteric fractures fixed with a sliding screw device alone or the same device combined with Norian SRS for augmentation. Using RSA it was shown that augmentation significantly improved the fracture stability until healing. In a randomized multicenter study including 112 patients, augmentation with Norian SRS reduced pain during early rehabilitation and improved quality of life until healing. </p><p>In conclusion, augmentation with Norian SRS improved the early fracture stability in displaced femoral neck fractures while there was no major difference in clinical outcome. In unstable trochanteric fractures augmentation provided improved fracture stability and improved clinical course until healing. </p>
80

Surgical resource balance a model for minimizing total cost : submitted to the Program in Hospital Administration ... in partial fulfillment ... for the degree of Master of Health Services Administration /

Wellman, Brynn T. January 1976 (has links)
Thesis (M.H.S.A.)--University of Michigan, 1976.

Page generated in 0.0253 seconds